二甲双胍和罗格列酮对肥胖型PCOS治疗作用的对照性研究

目的观察罗格列酮和二甲双胍联合氯米芬治疗肥胖型多囊卵巢综合征患者的内分泌改善及生殖功能的临床疗效。方法50例肥胖型PCOS患者分别给予罗格列酮4mg/d和二甲双胍1500mg/d联合氯米芬100mg/d,治疗3个月,比较治疗前后体重指数、内分泌参数、腰臀比和Hom a IR的变化。结果用罗格列酮治疗后排卵率为88%,周期排卵率为64.29%,优势卵泡平均个数为1.8±0.8个,妊娠率为56%,而用二甲双胍治疗后分别为72%、54.84%、1.1±0.6个、48%。两者治疗后能使LH、LH/FSH、T的血清浓度明显下降,SHBG的浓度明显上升,Hom a IR明显改善。结论罗格列酮和二甲双胍联合氯米芬治疗肥胖型多囊卵巢综合征疗效可靠。二甲双胍有降低体重作用、价格便宜,适用于肥胖型P-COS伴胰岛素抵抗不严重者;罗格列酮在胰岛素增敏作用优于二甲双胍,适用于胰岛素抵抗较严重的PCOS患者。     

Effects of 12 weeks of aerobic exercise plus dietary restriction on body composition,resting energy expenditure and aerobic fitness in mildly obese middle-aged women

This study investigated the effects of 12 weeks of aerobic exercise plus voluntary food restriction on the body composition, resting metabolic rate (RMR) and aerobic fitness of mildly obese middle-aged women. The subjects were randomly assigned to exercise/diet (n = 17) or control (n = 15) groups. The exercise/diet group participated in an aerobic training programme, 45–60 min · day ^–1 at 50%–60% of maximal oxygen uptake (VO_2max), 3–4 days · week^–1, and also adopted a self-regulated energy deficit relative to predicted energy requirements (–1.05 MJ · day ^–1 to –1.14 MJ · day ^–1 ). After the regimen had been followed for 12 weeks, the body mass of the subjects had decreased by an average of 4.5 kg, due mainly to fat loss, with little change of fat free mass (m _ff). The absolute RMR did not change, but the experimental group showed significant increases in the RMR per unit of body mass (10%) and the RMR per unit of m _ff (4%). The increase in RMR/m _ff was not correlated with any increase in VO_2max/m _ff. The resting heat production per unit of essential body mass increased by an average of 21%, but the resting heat production rate per unit of fat tissue mass remained unchanged. We concluded that aerobic exercise enhances the effect of moderate dietary restriction by augmenting the metabolic activity of lean tissue.     

Impact of maternal pre-pregnancy body mass index on maternal,fetal and neonatal adverse outcomes in the worldwide populations: A systematic review and meta-analysis

ObjectiveSystematic review and meta-analysis conducted to investigate the effect of stratified pre-pregnancy maternal body mass index on twenty maternal and fetal/neonatal adverse outcomes.MethodsPubMed, Google Scholar, Medline, Embase, Web of Science databases were searched from inception till July 11, 2020. Cohort studies were included. The pooled odds ratio with 95% confidence interval was reported considering the random effect and the quality effect model. The sub-group analysis and meta-regression were conducted for BMI cut-offs, geographical region, source of BMI, and sample size.ResultsOverall, 86 studies representing 20,328,777 pregnant women were included in this meta-analysis. Our study reveals that overweight and obese mothers are at increased odds of cesarean delivery, elective cesarean delivery, emergency cesarean delivery, gestational diabetes, gestational hypertension, induction of labor, postpartum hemorrhage, pre-eclampsia, pre-term premature rupture of membrane, and the fetuses/neonates of overweight and obese mothers are at increased risk of admission in the newborn intensive care unit, APGAR scores less than 7 at 5 min, large for gestational age, macrosomia, extreme pre-term birth in pregnant mothers compared with standard BMI mothers. However, the underweight mothers showed increased odds for small for gestational age infant and pre-term birth, whereas obese mothers were at higher risk for post-term birth and stillbirths. The subgroup and meta-regression analyses have shown the impact of BMI cut-offs, geographical region, source of BMI, and sample size on several maternal, fetal/neonatal adverse outcomes.ConclusionThe meta-analysis confirmed the association of elevated pre-pregnancy maternal BMI with higher odds of adverse maternal and fetal/neonatal outcomes.     

Mental health and socioeconomic status impact adherence to youth activity and dietary programs: a meta-analysis

PurposeSubstantial efforts have gone into reducing the physiological and psychological harm of obesity in youth, but few studies have reviewed the factors contributing to adherence to pediatric weight management programs. The attrition rates to programs offering multiple components to address BMI improvement and healthy lifestyle change among youth are quite high. The purpose of this study is to review the literature for factors contributing to adherence to these programs among children and youth with obesity and determine pooled effect of these factors.MethodsA systematic literature search and meta-analysis was conducted through the PubMed database on pediatric weight management interventions offering at least physical activity and dietary support for obese youth aged 10–17 years, where variables contributing to adherence were reported. Only those studies achieving a threshold of methodological rigour were included.ResultsAltogether, seven studies were included in the analysis. There was a pooled RR of lower socioeconomic status on non-adherence of 1.34 [95% confidence intervals 1.19–1.52] and poorer mental health on non-adherence of 1.12 [95% confidence intervals 1.08–1.17].ConclusionIt is important to address barriers related to lower socioeconomic status in pediatric weight management programs to increase adherence. Further, addressing supports for those with poorer mental health can reduce the risk of non-adherence in multi-disciplinary programs targeting youth with obesity.     

Anti-HIV I antibodies prevalence in parturients through newborn testing: Results of the Italian anonymous serosurvey

A prevalence assessment of HIV infection among parturients was performed in order to estimate the future incidence of pediatric AIDS cases and obtain data on the trend of the infection in Italy.Consecutive whole blood samples from newborns collected on filter paper from all regions of Italy (October-December 1990) for routine metabolic screenings, were anonymously examined for HIV-1 antibodies by an ELISA technique. Positive results were confirmed by Western blot.Among 97,658 blood samples tested, 121 (0.124%, 95% confidence interval Poisson distribution 0.103–0.148) were positive. A high prevalence of HIV infection (> 0.2%) was observed in four regions from North and Central Italy while, in some regions in the South, the seroprevalence was ten times lower. In the Lazio Region, namely in Rome, 5 inner-city hospitals with a particularly high prevalence of HIV infection were identified.Assuming that the prevalence of HIV infection observed in the population in this study may reflect the infection rate in the total population of childbearing women, we estimate that approximately 700 newborn babies were delivered from HIV-positive mothers in Italy during 1990. The identification of high prevalence areas could allow for the development of targeted testing programs to plan and provide adequate counselling and care of HIV-infected women and their infants.U. Angeloni (Roma), I. Antonozzi (Roma), R. Beghini (Verona), S. Carta (Roma), R. Ciannainea (Lecce), L. Chiovato (Tirrenia), V.D. Dainato (Foggia), G.C. Fiorucci (Torino), R. attei (Siena), A. Bracco (Napoli), A. Misserini (Taranto), E. Pasquini (Firenze), S. Piazzi (Bologna), L. Piceni-Sereni (Milano), A. Pignero (Napoli), C. Pintor (Cagliari), G. Pugliese (Potenza), C. Romano (Genova), V. Rossolini (Fano).     

肥胖儿童血管内皮运动功能障碍及其对左心结构和血压的影响

目的观察肥胖儿童早期血管内皮功能改变及其对左心结构和血压的影响。方法学龄期单纯性肥胖儿童及正常对照儿童各40例,分别测定血浆内皮素(ET)、6-酮前列环素(6-k-PGF     

泰安市中小学生肥胖现况及高血压危险因素研究

目的了解泰安市中小学生肥胖现况,探讨引起中小学生高血压的危险因素,以便为成年期疾病早期预防的研究提供依据.方法采用现况调查和危险因素病例对照研究法进行研究.结果泰安市中小学生高血压、超重和肥胖的检出率分别为5.48%,5.48%和5.88%;男生检出率显著高于女生,检出率随着年龄增长而升高.肥胖,高盐、高脂、高热饮食,缺乏运动及家族史是高血压主要患病危险因素.结论男生和高中学生是预防干预的重点人群;学校、学生和家长应密切配合,共同努力,才能取得预防干预的满意效果.     

干扰肥胖小鼠心肌组织中CPT1b的表达对活性氧簇代谢的影响

摘 要 目的 研究干扰肥胖小鼠心肌CPT1b的表达对心肌活性氧簇（ROS）的影响。方法 4周龄的雄性C57小鼠，随机分为三组，分别为正常对照组（N-mock）、肥胖对照组（O-mock）及肥胖干预组（O-CPT1b），对肥胖组小鼠进行高脂饮食造肥胖模型。6周龄时，向干预组小鼠心肌注射靶向CPT1b （O-CPT1b）或靶向无关基因（N-mock、O-mock）的重组慢病毒。继续喂养10周后，取小鼠心肌，Western blot检测CPT1b的蛋白表达量；行油红O染色检测心肌组织中性脂质含量；使用冷冻切片染色法及流式细胞术检测心肌细胞中 ROS。结果 RT-PCR 和Western blot结果显示，携带CPT1b基因的短发夹RNA显著下调了O-CPT1b小鼠心肌组织中CPT1b的表达；肥胖引起心肌组织内中性脂质蓄积增多，下调CPT1b的表达增加了心肌内中性脂质的含量；高脂饮食还导致心肌ROS的含量显著增加，而下调CPT1b的表达可以改善甚至逆转这一进程。结论 CPT1b在肥胖小鼠心肌的ROS生成增多中起重要作用，下调小鼠心肌组织的CPT1b表达或许会通过减轻心肌氧化应激而改善肥胖性心脏重构。